Contract Pharmacy Details

WALGREEN CO.
CH040390 MEDLINK GEORGIA, INC.

Covered Entity Details

Entity Name

MEDLINK GEORGIA, INC.

Subdivision Name

Medlink Colbert

Type

HRSA-Funded Health Center

340B ID

CH040390

Entity Address

11 CHARLIE MORRIS RD
COLBERT, GA 30628

Grant Number

H80CS00427

Participating Start Date

7/1/2005

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09706
472 S ENOTA DR NE
GAINESVILLE, GA 30501

Pharmacy Comments

Contract Details

Approval Date

10/18/2011

Contract Begin Date

10/18/2011

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Steven E. Smith, Chief Executive Officer
(706) 788-3234 Ext: 230

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/20/2011

340B Drug Pricing Program Database